Gc-globulin: roles in response to injury.

BACKGROUND Gc-globulin (vitamin D-binding protein) appears to have important functions in addition to its role as a carrier of vitamin D. APPROACH We reviewed recent studies focusing on the pathophysiologic functions and clinical significance of Gc-globulin. RESULTS Serum concentrations of Gc-globulin, as determined by immunoassay techniques, are decreased in severe injury. The extent of the decrease may have prognostic significance for patient outcomes. Clinical studies and animal models have shown that Gc-globulin has an important role in the clearance of procoagulant actin from the circulation after its release during cell necrosis and tissue injury. Gc-globulin has other potential roles in responses to acute tissue injury through conversion to a macrophage-activating factor, neutrophil chemotactic activity, and enhancement of C5a-mediated signaling. CONCLUSION Considering the important physiologic roles of Gc-globulin in responses to tissue injury, such as clearance of actin, measurement of Gc-globulin may have value in directing the care of patients in many clinical disorders.